In November 2019, the Centers for Medicare & Medicaid Services (CMS) officially proposed a comprehensive regulation on Medicaid fiscal accountability. To facilitate review of the rule, HMA staff have created an overview of key elements of the proposed regulation and summary. This document is designed to give a framework to analyze the proposal and provides analysis in most sections. The HMA team can provide in-depth policy support unique and local issues may require.
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Final HMA-authored reports on reproductive care access released
A final report and series of five case studies, Beyond the Numbers: Access to Reproductive Health Care for Low-Income Women in Five Communities, have been released.
Working with the Kaiser Family Foundation (KFF), a team of HMA colleagues, Managing Principal Sharon Silow-Carroll, Consultant Carrie Rosenzweig, Senior Consultant Diana Rodin, and Principal Rebecca Kellenberg, completed the project.
Through state policy reviews, site visits, interviews with local stakeholders, and focus groups with low income women, the team examined how national, state, and local policies, as well as cultural factors, shape access to contraceptive care, sexually transmitted infection prevention and treatment, obstetrical care, and abortion services. The study focused on the on-the-ground experiences of women living in these communities and the reproductive health professionals caring for them.
The study identified themes that cut across all five “medically underserved” communities but play out in different ways depending on the local environment. The key factors influencing access include cultural and social determinants of health, healthcare coverage, provider supply and distribution, sex education, and abortion policies and environment.
In addition to an executive summary report, KFF has also published case study briefs that detail the findings in each of the five communities. The complete report is available here.
California Releases Medicaid Delivery System Waiver Proposal
This week, our In Focus section reviews the California Advancing and Innovating Medi-Cal (CalAIM) proposal, issued by the California Department of Health Care Services (DHCS) on October 28, 2019. CalAIM would implement broad delivery system, program, and payment reform for the state’s Medicaid program. The proposal includes efforts to address social determinants of health and other policy priorities such as homelessness, lack of access to behavioral health care, children with complex medical conditions, justice-involved populations, and aging individuals. According to DHCS, the three key goals of the proposal are to:
Albany and New York City HMA Offices Host First Regional Provider Conference
On November 13, HMA’s Albany and New York City offices hosted their first regional provider conference, “Make Your New Risk Model Pay: How New York Healthcare Providers are Making Population Health Sustainable.” Roughly 120 people attended the event.
Issue brief explores child care needs of families experiencing homelessness
Recently, the HMA Community Strategies team of Managing Director Marci Eads, Principal Catherine Guerrero, Senior Associate Robyn Odendahl, Research Assistant Rathi Ramasamy and Principal Charles Robbins, contributed to a research project conducted in Los Angeles: Child Care Needs of Families Experiencing Homelessness.
Funded by the Child Care Resource Center, the study’s purpose was to understand the needs of families experiencing homelessness with children ages zero to five living in Los Angeles County Service Planning Areas 1 and 2 (San Fernando and Antelope Valleys). Through multiple sources of data including a literature review, publicly available data on homelessness in Los Angeles County, interviews with national and local experts and focus group with families experiencing homelessness, the research highlighted a need to develop and expand access to child care resources specifically designed for families experiencing homelessness.
New Medicare Benefit: Opioid Use Disorder Treatment
This week, our In Focus section examines the new Medicare benefit for Opioid Use Disorder (OUD) treatment that includes counseling, as well as medication-assisted treatment (MAT) and related items and services. This benefit was established by Congress in the SUPPORT Act of 2018 and is now being implemented by the Centers for Medicare & Medicaid Services (CMS). Medicare beneficiaries, including those dually eligible for Medicare & Medicaid, are the fastest growing group of OUD patients. Beneficiaries may access one of two types of providers: Opioid Treatment Programs (OTPs) (i.e., methadone clinics), or physicians + other health professionals. Providers offering these services will receive a bundled payment, either weekly or monthly depending on the type of provider, that can repeat as long as a patient needs treatment. Based on early guidance, Medicare Advantage (MA) plans have already created 2020 benefit packages that provide a level of access to OTP services that is “consistent with prevailing community patterns of care.” Now that the new benefit is final, MA will need to cover both OTP & Physician OUD treatment for 2021.
HMA Colleagues Lead Health Reproductive Care Access Study
Health Management Associates (HMA), working with the Kaiser Family Foundation, recently conducted research and completed five case studies to identify distinct challenges that low-income women face in obtaining reproductive healthcare in five diverse communities, and the key factors contributing to them.
Indiana Releases Hoosier Care Connect Managed Care RFP
This week, our In Focus section reviews the Indiana Hoosier Care Connect request for proposals (RFP), issued by the Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) on October 18, 2019. Hoosier Care Connect is the state’s Medicaid managed care program for approximately 90,000 aged, blind, and disabled (ABD) Medicaid beneficiaries. Implementation is expected April 1, 2021, with contracts worth $1.4 billion annually.